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Medical device



 
 
A medical device is an object which is useful for diagnostic or therapeutic purposes. Examples of medical devices include medical thermometer
Medical thermometer

Medical thermometers are used for Temperature examination human body temperature, with the tip of the thermometer being inserted either into the mouth , under the underarm , or into the rectum via the anus ....
s, blood sugar meter
Blood glucose monitoring

Blood glucose monitoring is a way of testing the concentration of glucose in the blood .It is important in the care of diabetes mellitus. A blood glucose test is performed by piercing the skin to draw blood, then placing the blood on a chemically active disposable strip which indicates the result either by changing colour, or changing an...
s, and X-ray machine
X-ray machine

An X-ray machine is a device used by radiographers to acquire an x-ray image. They are used in various fields, notably medicine and security....
s.

ctive 2007/47/ec of the European Parliament
European Parliament

The European Parliament is the only direct election parliamentary institution of the European Union . Together with the Council of the European Union , it forms the bicameral Institutions of the European Union#Legislature of the Institutions of the European Union and has been described as one of the most powerful legislatures in the world....
 and of the council of 5 September, 2007, which amended the Council Directive 93/42/EEC of 14 June, 1993 concerning medical devices, defines a medical device as any instrument, apparatus, appliance, software, material or other article, whether used alone or in combination, including the software intended by its manufacturer to be used specifically for diagnostic and/or therapeutic purposes and necessary for its proper application, intended by the manufacturer to be used for human beings.






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Encyclopedia


A medical device is an object which is useful for diagnostic or therapeutic purposes. Examples of medical devices include medical thermometer
Medical thermometer

Medical thermometers are used for Temperature examination human body temperature, with the tip of the thermometer being inserted either into the mouth , under the underarm , or into the rectum via the anus ....
s, blood sugar meter
Blood glucose monitoring

Blood glucose monitoring is a way of testing the concentration of glucose in the blood .It is important in the care of diabetes mellitus. A blood glucose test is performed by piercing the skin to draw blood, then placing the blood on a chemically active disposable strip which indicates the result either by changing colour, or changing an...
s, and X-ray machine
X-ray machine

An X-ray machine is a device used by radiographers to acquire an x-ray image. They are used in various fields, notably medicine and security....
s.

Definitions


European definition

Directive 2007/47/ec of the European Parliament
European Parliament

The European Parliament is the only direct election parliamentary institution of the European Union . Together with the Council of the European Union , it forms the bicameral Institutions of the European Union#Legislature of the Institutions of the European Union and has been described as one of the most powerful legislatures in the world....
 and of the council of 5 September, 2007, which amended the Council Directive 93/42/EEC of 14 June, 1993 concerning medical devices, defines a medical device as any instrument, apparatus, appliance, software, material or other article, whether used alone or in combination, including the software intended by its manufacturer to be used specifically for diagnostic and/or therapeutic purposes and necessary for its proper application, intended by the manufacturer to be used for human beings. Devices are to be used for the purpose of:

  • Diagnosis, prevention, monitoring, treatment or alleviation of disease.
  • Diagnosis, monitoring, treatment, alleviation of or compensation for an injury or handicap.
  • Investigation, replacement or modification of the anatomy or of a physiological process
  • Control of conception


This includes devices that do not achieve its principal intended action in or on the human body by pharmacological, immunological or metabolic means, but which may be assisted in its function by such means.

The Medicines and Healthcare products Regulatory Agency
Medicines and Healthcare products Regulatory Agency

The Medicines and Healthcare products Regulatory Agency is the UK government agency which is responsible for ensuring that medicines and medical devices work and are acceptably safe....
 (MHRA) regulates medical devices in the UK under European legislation. Medical devices must not be mistaken with medicinal products
Medicinal product

A medicinal product is defined in the European Union as any substance or combination of substances presented for treatment or prevention disease in human beings....
.

Definition in USA by the Food and Drug Administration

A medical device, according to the U.S. Food and Drug Administration (FDA), is an instrument
Tool

A broad definition of a tool is an entity used to interface between two or more domains that facilitates more effective action of one domain upon the other....
, apparatus, implement, machine
Machine

A machine is any device that uses energy to perform some activity. In common usage, the meaning is that of a device having parts that perform or assist in performing any type of work....
, contrivance, implant
Implant (medicine)

An implant is a medical device made to replace and act as a missing biological structure . The surface of implants that contact the body might be made of a biomedical material such as titanium, silicone or apatite depending on what is the most functional....
, in vitro
In vitro

In vitro refers to the technique of performing a given procedure in a controlled environment outside of a living organism. Some may argue that in vitro refers to a process that is created in a "test tube"; however, Robert Kail and John Cavanaugh on page 58 in the 4th edition of Human Development: A Life-Span View cite that in fact th...
 reagent
Reagent

A reagent or reactant is a substance or compound consumed during a chemical reaction. Solvents and catalysts, although they are involved in the reaction, are usually not referred to as reactants....
, or other similar or related article, including a component part, or accessory which is:
  • recognized in the official National Formulary
    National Formulary

    A National Formulary is a manual containing a list of medicines that are approved for prescription throughout the country, indicating which products are interchangeable....
    , or the United States Pharmacopoeia, or any supplement to them,
  • intended for use in the diagnosis
    Diagnosis

    Diagnosis is the identification of the nature of anything, either by process of elimination or other analytical methods. Diagnosis is used in many different disciplines, with slightly different implementations on the application of logic and experience to determine the cause and effect relationships....
     of disease
    Disease

    A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and Medical signs....
     or other conditions, or in the cure, mitigation, treatment, or prevention
    Prevention (medical)

    In medicine, prevention is any activity which reduces the burden of mortality or morbidity from disease. This takes place at primary, secondary and tertiary prevention levels....
     of disease, in man or other animals, or
  • intended to affect the structure or any function of the body of man or other animals, and which does not achieve any of its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized
    Metabolism

    Metabolism is the set of chemical reactions that occur in living organisms in order to maintain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments....
     for the achievement of any of its primary intended purposes.
as defined by the Federal Food, Drug, and Cosmetic Act, 21 United States Code
United States Code

The United States Code is a compilation and codification of the general and permanent federal law of the United States. ...
 [321] (h).

Definition in Canada by the Food and Drugs Act

The term medical devices, as defined in the Food and Drugs Act
Food and Drugs Act

Food and Drugs Act is an Act of the Parliament of Canada regarding the production, import, export, transport across provinces and sale of food, approved drug, contraceptive devices and cosmetics ....
, covers a wide range of health or medical instruments used in the treatment, mitigation, diagnosis or prevention of a disease or abnormal physical condition. Health Canada reviews medical devices to assess their safety, effectiveness and quality before being authorized for sale in Canada.

Classification


Canada

The Medical Devices Bureau of Health Canada has recognized four classes of medical devices based on the level of control necessary to assure the safety and effectiveness of the device.

United States

The Food and Drug Administration has recognized three classes of medical devices based on the level of control necessary to assure the safety and effectiveness of the device. The classification procedures are described in the Code of Federal Regulations
Code of Federal Regulations

File:Codeoffederalregulations.jpgThe Code of Federal Regulations is the codification of the general and permanent rules and regulations published in the Federal Register by the executive departments and agencies of the Federal Government of the United States....
, Title 21, part 860 (usually known as 21 CFR 860).

Class I: General Controls
Class I devices present minimal potential for harm to the user and are often simpler in design than Class II or Class III devices. These devices are subject only to general controls. General controls cover such issues as manufacturer registration with the FDA, good manufacturing techniques, proper branding and labelling, notification of the FDA before marketing the device, and general reporting procedures. (Most Class I devices are exempt from the good manufacturing practices and/or the FDA notification regulations.) These controls are deemed sufficient to provide reasonable assurance of the safety and effectiveness of the device; or the device is not life-supporting or life-sustaining and does not present a reasonable source of injury
Injury

Injury or bodily injury is damage or harm caused to the structure or Purpose of the body caused by an outside wiktionary:agent or force, which may be physical or chemical....
 through normal usage. Devices in this category include tongue depressors, bedpan
Bedpan

A bedpan or bed pan is an object used for the toileting of a bedridden patient in a health care facility, usually made of a metal, glass, or plastic receptacle....
s, elastic bandage
Bandage

A bandage is a piece of material used either to support a medical device such as a dressing or splint , or on its own to provide support to the body....
s, examination gloves, and hand-held surgical instruments and other similar types of common equipment. Depending on the "stated/purported use" of a device, it may be necessary to obtain a Premarket Approval or 510K for the device, which is otherwise classifiable as a Class 1 device. Such devices are referred to as "reserved devices". The electrically powered arthroscope (which is really an endoscope powered electrically) is a case in point. While endoscopes are Class 1 devices, the electrically powered arthroscopes need a pre-market notification (510K) although the manual arthroscopes do not. Pre-market notified devices are marketed as "at least as safe and effective, that is, substantially equivalent, to a legally marketed device."

Class II: General Controls with Special Controls
Class II devices are those for which general controls alone are insufficient to assure safety and effectiveness, and additional existing methods are available to provide such assurances. Therefore, Class II devices are also subject to special controls in addition to the general controls of Class I devices. Special controls may include special labeling requirements, mandatory performance standards, and postmarket surveillance. Devices in Class II are held to a higher level of assurance than Class I devices that they will perform as indicated and will not cause injury or harm to patient or user. Devices in this class are typically non-invasive and include x-ray
X-ray

X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 10 to 0.01 nanometers, corresponding to frequency in the range 30 Hertz to 30 Hertz and energies in the range 120 Electron volt to 120 keV....
 machines, PACS
Picture archiving and communication system

In medical imaging, picture archiving and communication systems are computers or networks dedicated to the storage, retrieval, distribution and presentation of images....
, powered wheelchair
Wheelchair

A wheelchair is a wheeled mobility device in which the user sits. The device is propelled either manually or via various automated systems. Wheelchairs are used by people for whom walking is difficult or impossible due to illness , injury, or disability....
s, infusion pump
Infusion pump

An infusion pump infusion fluids, medication or nutrients into a patient circulatory system. It is generally used intravenously, although subcutaneous, artery and epidural infusions are occasionally used....
s, surgical drapes, surgical needles and suture material, and acupuncture
Acupuncture

Acupuncture is a technique of inserting and manipulating fine wikt:filiform needles into specific points on the body to relieve pain or for therapeutic purposes....
 needles.

Class III: General Controls and Premarket Approval
A Class III device is one for which sufficient information exists to assure safety and effectiveness solely through the general or special controls sufficient for Class I or Class II devices. Such a device needs premarket approval, a scientific review to ensure the device's safety and effectiveness, in addition to the general controls of Class I. Class III devices are described as those for which "insufficient information exists to determine that general controls are sufficient to provide reasonable assurance of its safety and effectiveness or that application of special controls ... would provide such assurance and if, in addition, the device is life-supporting or life-sustaining, or for a use which is of substantial importance in preventing impairment of human health, or if the device presents a potential unreasonable risk of illness or injury."

Examples of Class III devices which require a premarket approval include replacement heart valve
Artificial heart valve

An artificial heart valve is a device which is implanted in the heart of patients who suffer from valvular diseases in their heart. When one or two of the four heart valves of the heart have a malfunction, the choice is normally to replace the natural valve with an artificial valve....
s, silicone
Silicone

Silicones are largely inert, man-made compounds with a wide variety of forms and uses. Typically heat-resistant, nonstick, and rubberlike, they are commonly used in cookware, medicine, sealants, adhesives, lubricants, and insulation....
 gel-filled breast implants, implanted cerebral stimulators, implantable pacemaker
Artificial pacemaker

A pacemaker is a medical device which uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart....
 pulse generators and endosseous (intra-bone) implants (with the exception of root-form endosseous dental implants which were recently reclassified as Class II).

European Union (EU) and European Free Trade Association (EFTA)

The classification of medical devices in the European Union is outlined in Annex IX of the Council Directive 93/42/EEC. There are basically four classes, ranging from low risk to high risk.

  • Class I (including Is & Im)
  • Class IIa
  • Class IIb
  • Class III


The authorization of medical devices is guaranteed by a Declaration of Conformity
Declaration of Conformity

Declaration of Conformity is the debut studio album by the American Rock music band Wellwater Conspiracy. It was released on June 17, 1997 through Third Gear Records....
. This declaration is issued by the manufacturer itself, but for products in Class Is, Im, IIa, IIb or III, it should be backed by a Certificate of Conformity of so-called Notified Body (i.e. an organisation accredited to validate the compliance of the device to the European Directive). Medical devices that pertain to class I (on condition they do not need to be sterilised or are not used to measure a function) can be put on the market purely by self-certification.

The European classification depends on rules that involve the medical device's duration of body contact, its invasive character, its use of an energy source, its effect on the central circulation or nervous system, its diagnostic impact or its incorporation of a medicinal product.

Certified medical devices should have the CE mark
CE mark

For other uses, see CE.The CE marking is a mandatory conformity mark on many products placed on the single market in the European Economic Area ....
 on the packaging, insert leaflets, etc.. These packagings should also show harmonised pictograms and EN
EN

EN, En or en can mean:...
 standardised logos to indicate essential features such as instructions for use, expiry date, manufacturer, sterile, don't reuse, etc.

List of medical devices


High risk devices

High risk devices are life supports, critical monitoring, energy emitting and other devices whose failure or misuse is reasonably likely to seriously injure patient or staff. Examples includes
  • Anesthesia ventilators
  • Anesthesia units
  • Apnea monitors
  • Argon enhanced coagulation units
  • Aspirators
  • Auto transfusion units
  • Invasive Blood pressure units
  • Fetal monitors
  • Electrosurgical units
  • Incubators
  • Infusion pump
  • Pulse oximeters
  • External pacemaker
  • Heart Lung Machine


Medium risk devices

These are devices including many diagnostic instruments whose misuse, failure or absence (e.g. out of service) with no replacement available would have a significant impact on patient care, but would not be likely to cause direct serious injury. Examples are

  • ECG
  • EEG
  • Treadmills
  • Ultrasound sensors
  • Phototherapy units
  • Endoscopes
  • Surgical drill and saws
  • Laparoscopic insufflators
  • Phonocardiographs
  • radiant warmers (Adult)
  • Ansiscope - Diabetic diagnostic Device
  • Zoophagous agents (e.g., medicinal leeches; medicinal maggots)
  • Lytic Bacteriophages


Low risk devices

Devices in this category are those whose failure or misuse is unlikely to result in serious consequences. Some examples for such equipments include
  • Electronic thermometer,
  • Breast pumps
  • Surgical microscope
  • Ultrasonic nebulizers
  • Sphygmomanometers
  • Surgical table
  • Surgical lights.
  • Temperature monitor
  • Aspirators
  • X-rays diagnostic equipment


See also

  • Biomedical engineering
    Biomedical engineering

    Biomedical engineering is the application of engineering principles and techniques to the medical field. It combines the design and problem solving skills of engineering with medical and biological sciences to help improve patient health care and the quality of life of individuals....
  • Biomedical equipment technician
    Biomedical Equipment Technician

    A biomedical equipment technician is a highly skilled technologist that ensures that medical equipment is serviceable, safe, and properly configured....
  • Clinical engineering
    Clinical engineering

    Clinical engineering is a specialty within Biomedical engineering responsible primarily for applying and implementing medical technology to optimize healthcare delivery....
  • Design history file
    Design history file

    Design History File is a compilation of Document that describes the design history of a finished medical device. The design history file, or DHF, is part of regulation introduced in 1990 when the U.S....
  • Durable medical equipment
    Durable medical equipment

    Durable medical equipment is a term of art used to describe any medical equipment used in the home to aid in a better quality of living. It is a benefeit included in most Insurances....
  • GHTF
  • Home medical equipment
    Home medical equipment

    This article discusses the definitions and types of home medical equipment , also known as durable medical equipment , prosthetics and orthotics ....
  • ISO 13485
    ISO 13485

    ISO 13485 is an ISO standard, published in 2003, that represents the requirements for a comprehensive management system for the design and manufacture of medical devices....
  • Medical equipment
    Medical equipment

    Medical equipment is designed to aid in the diagnosis, monitoring or treatment of medical conditions. These devices are usually designed with rigorous safety engineering....


External links

  • - ISO standard series